Method and kit for determining the genome integrity and/or the quality of a library of dna sequences obtained by deterministic restriction site whole genome amplification

ABSTRACT

A method for determining the integrity of the genome of a sample and/or the quality of a library of DNA sequences obtained by deterministic restriction site whole genome amplification can include (a) amplifying the library of DNA sequences to produce first, second, and third PCR products each of a different size from 50 bp to 1000 bp, by PCR using at least one first primer pair, one second primer pair and one third primer pair, the primer pairs each hybridizing to a DNA sequence of the library having a length from 1000 bp to 5000 bp and corresponding to a sequence of the genome located respectively on a first, second and third chromosome arm; (b) detecting the first, second and third PCR products; (c) correlating the presence of the first, second and third PCR products with the integrity of the genome of the sample and/or the quality of the library.

The present invention relates to a method and a kit for determining theintegrity of the genome of a sample, in particular a single cell, and/orthe quality of a library of DNA sequences obtained by deterministicrestriction site whole genome amplification (DRS-WGA) of the genome ofthe sample.

STATE OF THE ART

Whole Genome Amplification (WGA) permits detection of somatic mutationsand copy alterations in DNA of limited starting material, such as in thecase of single circulating tumour cells (CTC) of cancer patients or inpreimplantation diagnostics.

For the diagnostic use of WGA for single cell analysis, quality ofgenomic DNA (i.e. genome integrity) of the single cell sample ofinterest plays a major role for successful molecular analysis after WGA.

In particular, CTCs have been described as being frequently apoptotic(Mehes, G., et al., Circulating breast cancer cells are frequentlyapoptotic. Am J Pathol, 2001. 159(1): p. 17-20).

Moreover, during caspase-mediated apoptosis genomic DNA is fragmentedinto small pieces of 180 bp to 200 bp length (Wyllie, A H.,Glucocorticoid-induced thymocyte apoptosis is associated with endogenousendonuclease activation. Nature, 1980. 284(5756): p. 555-6).

It is thus important to assess the Genome Integrity status of a singlecell, as this can be linked to the biological status of the cell itself,and give clinically relevant information on the overall status of acancer patient, which goes beyond the information provided by justcounting the CTCs and complements the molecular characterization ofthose CTCs.

Besides, DNA crosslinking and/or fragmentation occur with chemicaltreatment (e.g. fixation) applied on patient-derived cells and tissuesfor needed sample conservation after biopsy.

To predict performance of molecular assays for single cell analysis andevaluation of resulting data derived from such samples, assessing thegenomic integrity of single cells is of paramount importance.

Available single cell WGA kits assess quality of whole genomeamplification by measuring the concentration of the WGA product only. Asprotocols for these methods include at least one random step during theprocedure of single cell DNA amplification, specific assays to evaluategenome integrity of the input sample (in general a single cell) such asapoptotic or non-apoptotic status, or the quality of the output of theWGA product, such as the suitability for further genetic analysis, aredifficult.

A specific kind of WGA is deterministic restriction site whole genomeamplification (hereinafter referred to as DRS-WGA). DRS-WGA, which isknown from EP1109938 and is commercialised as Ampli1™ by SiliconBiosystems Spa, is based on specific restriction digestion of doublestranded DNA at MseI sites (TTAA) and ligation of a universal adaptorfor amplification.

DRS-WGA has been shown to be better for the amplification of singlecells (see for example: Lee Y S, et al: Comparison of whole genomeamplification methods for further quantitative analysis withmicroarray-based comparative genomic hybridization. Taiwan J ObstetGynecol. 2008, 47(1):32-41) and also more tolerant to DNA degradationdue to fixative treatment (see for example: Stoecklein N. H. et al:SCOMP is Superior to Degenerated Oligonucleotide Primed-PCR for GlobalAmplification of Minute Amounts of DNA from Microdissected ArchivalSamples. American Journal of Pathology 2002, Vol. 161, No. 1; Arneson N.et al.: Comparison of Whole Genome Amplification methods for analysis ofDNA extracted from microdissected early breast lesions in formalin-fixedparaffin-embedded tissue. ISRN Oncol. 2012; 2012;710692).

To date there are no specific assays to evaluate the genome integrity ofan input sample from the DRS-WGA product or the quality of the DRS-WGAproduct obtained.

A need is therefore felt to develop methods and kits allowing todetermine the genome integrity of an input sample and/or the quality ofthe DRS-WGA product obtained and permitting to predict performance ofmolecular assays downstream of DRS-WGA for single cell analysis andevaluation of resulting data.

An object of the present invention is therefore to provide a method fordetermining the integrity of the genome of a sample and/or the qualityof a library of DNA sequences obtained by DRS-WGA that provides robustand reliable results and allows in particular to assess the biologicalstatus of a cell/cells of the sample and/or predict the performance ofmolecular assays downstream of the DRS-WGA.

This object is achieved by the present invention as it relates to amethod as defined in claim 1.

It is a further object of the present invention to provide a kit asdefined in claim 8.

Definitions

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention pertains.

By the term “sample”, there is intended a sample comprising at least oneparticle of a biological entity, said particle comprising at least a DNAsequence representing the genome or a substantial subset of the genomeof that biological entity. By way of non-limiting example, said entitymay be a human, said at least one particle may be a set of 5 cells orless, a single cell, or a single-cell nucleus, or a haploid germ cell,or a chromosome.

By the term “genome” there is intended the entire genome or saidsubstantial subset of the genome.

By the term “integrity” of the genome there is intended the absence ofDNA damages such as double strand breaks, or nicks or similar conditionswhich may hamper the replication of the genome or its normalfunctionality.

By the term “quality” of a library of DNA sequences there is intendedthe suitability of the library of DNA sequences to be used for thegenetic characterization of certain features such as, by way ofnon-limiting example, the presence of point mutations, deletions,insertions, copy number variations.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an agarose gel picture of single marker PCRs, and of a4-multiplex assay and a 3-multiplex assay according to preferredembodiments of the present invention;

FIG. 2 shows an agarose gel picture of PCRs on PIK3CA hotspot 1 andhotspot2 (M=size marker, 0132 breast13, 02=breast15, 03=breast17,04=breast20, 05=prostate14, 06=prostate16, 07=prostate24, 0832melanoma13, 09=melanoma14, 10=melanoma16);

FIG. 3 shows an agarose gel picture of 8 samples tested by the preferred4-multiplex assay of FIG. 1.

FIG. 4 shows a histogram of the distribution of the Genome IntegrityIndex among single Circulating Tumour Cells (CTCs) and single leukocytes(WBCs) from breast cancer patients.

DETAILED DESCRIPTION OF THE INVENTION

The method according to the present invention for determining theintegrity of the genome of a sample and/or the quality of a library ofDNA sequences obtained by deterministic restriction site whole genomeamplification (DRS-WGA) of the genome of the sample comprises steps (a)to (d).

By allowing the determination of the integrity of the genome of a sampleand/or the quality of a library of sequences obtained by DRS-WGA of thegenome of the sample, the method also allows to assess the biologicalstatus of of a cell/cells of the sample and/or predict the success rateof genetic analysis assays on the library of DNA sequences.

The sample preferably consists of 5 cells or less, more preferably thesample is a single cell. The single cell is preferably a circulatingtumour cell (CTC), a circulating fetal cell, a circulating endothelialcell (CEC), an oocyte, a cumulus cell, a sperm, a blastomere, or atrophectoderm cell.

In step (a), the library of DNA sequences is provided.

In step (b), the library of DNA sequences is amplified by PCR using atleast one first primer pair which hybridises to a DNA sequence of thelibrary having a length from 1000 bp to 5000 bp, preferably from 1000 bpto 2000 bp, and corresponding to a sequence of the genome located on afirst chromosome arm, the step of amplifying giving rise to a first PCRproduct from 50 bp to 1000 bp.

Preferably, the DNA sequence of the library to which the first primerpair hybridises encompasses the D5S2117 region of chromosome 5q.

More preferably, the forward primer of the first primer pair is SEQ IDNO:4 and the reverse primer of the first primer pair is SEQ ID NO:3.

In step (c) the first PCR product is detected. Agarose gelelectrophoresis may be used to separate and detect the PCR product aswell as other methods known in the art.

In step (d) the presence of the first PCR product is correlated with theintegrity of the genome of the sample and/or the quality of the libraryof DNA sequences.

Advantageously, in step (b) at least one second primer pair is usedwhich hybridises to a DNA sequence of the library having a length from1000 bp to 5000 bp, more preferably from 1000 bp to 2000 bp, andcorresponding to a sequence of the genome located on a second chromosomearm other than the first chromosome arm, the step of amplifying givingrise to a second PCR product from 50 bp to 1000 bp having a size otherthan the first PCR product.

The second PCR product is also detected in step (c) and the presence ofthe second PCR product is also correlated with the integrity of thegenome of the sample and/or the quality of the library of DNA sequencesin step (d).

Preferably, the DNA sequence of the library to which the second primerpair hybridises encompasses exons 2 and 3 of the TRP53 gene.

More preferably, the forward primer of the second primer pair is SEQ IDNO:6 and the reverse primer of second primer pair is SEQ ID NO:5.

Advantageously, in step (b) at least one third primer pair is used whichhybridises to a DNA sequence of the library having a length from 1000 bpto 5000 bp, more preferably from 1000 bp to 2000 bp, and correspondingto a sequence of the genome located on a third chromosome arm other thanthe first and second chromosome arms, the step of amplifying giving riseto a third PCR product from 50 bp to 1000 bp having a size other thanthe first and second PCR products.

The third PCR product is also detected in step (c) and the presence ofthe third PCR product is also correlated with the integrity of thegenome of the sample and/or the quality of the library of DNA sequencesin step (d).

Preferably, the DNA sequence of the library to which the third primerpair hybridises encompasses the KRT19 pseudo-gene 1 (indicated for shortas CK19).

More preferably, the forward primer of the third primer pair is SEQ IDNO:8 and the reverse primer of the third primer pair is SEQ ID NO:7.

Even more preferably, in step (b) at least one fourth primer pair isused which hybridises to a DNA sequence of the library having a lengthfrom 80 bp to 300 bp, the step of amplifying giving rise to a fourth PCRproduct from 50 bp to 200 bp having a size other than the first, thesecond and the third PCR products.

When step (b) uses at least one fourth primer pair, the fourth PCRproduct is also detected in step (c) and the presence of the fourth PCRproduct is also correlated with the integrity of the genome of thesample and/or the quality of the library of DNA sequences in step (d).

Preferably, the DNA sequence of the library to which the fourth primerpair hybridises encompasses codons 12 and 13 of the KRAS gene.

Even more preferably, the forward primer of the fourth primer pair isSEQ ID NO:17 and the reverse primer of the fourth primer pair is SEQ IDNO:18.

According to the present invention there is also provided a kit fordetermining the integrity of the genome of a sample and/or the qualityof a library of DNA sequences obtained by deterministic restriction sitewhole genome amplification (DRS-WGA) of the genome of the samplecomprising:

-   -   at least one first primer pair which hybridises to a DNA        sequence of the library having a length from 1000 bp to 5000 bp        and corresponding to a sequence of the genome located on a first        chromosome arm,    -   at least one second primer pair which hybridises to a DNA        sequence of the library having a length from 1000 bp to 5000 bp        and corresponding to a sequence of the genome located on a        second chromosome arm other than the first chromosome arm,    -   at least one third primer pair which hybridises to a DNA        sequence of the library having a length from 1000 bp to 5000 bp        and corresponding to a sequence of the genome located on a third        chromosome arm other than the first and second chromosome arms,        wherein the first, second and third primer pairs give rise, when        amplified by PCR, to PCR products having different size from one        another.

Preferably, the kit further comprises at least one fourth primer pairwhich hybridises to a DNA sequence of the library having a length from80 bp to 300 bp, wherein the first, second, third and fourth primerpairs give rise, when amplified by PCR, to PCR products having differentsize from one another.

More preferably, the kit comprises the first, second, third and fourthprimer pairs.

The kit may be used for predicting the success of a genetic analysisassay after amplification of single cell genomic DNA by DRS-WGA.Preferably the genetic analysis assay is Sanger sequencing for mutationanalysis, assessment of specific copy number changes, quantitative PCRfor gene amplification, metaphase Comparative Genomic Hybridisation(CGH), or array Comparative Genomic Hybridisation (CGH).

For gene specific assays, such as Sanger sequencing for mutationanalysis, samples with at least 1-2 out of 4 PCR products can be used.Positivity to at least 3 out of 4 PCR products is predictive ofsuccessful genome-wide analysis with metaphase CGH. For array CGH it isadvisable to use samples with 4 out of 4 positive PCR products.

The kit may also be used to determine the integrity of the genome of asample and thus determine the biological status of the cell/cells of thesample. The sample preferably consists of 5 cells or less, morepreferably the sample is a single cell.

As a matter of fact, if there is a large number of cells in the sample,there will be, overall, enough template copies for the first, second,third (and optionally fourth) primer pairs to amplify respectively thefirst, second, third (and optionally fourth) PCR products even if theDNA of the cells of the sample is highly fragmented. The result is theloss of the discrimination power of the method.

On the other hand, it has been experimentally determined that, even inthe case of very damaged DNA cell samples, 5 cells is an amount thatallows reliable results with the method, i.e allows to obtain the PCRproducts of step (d) without them being a results of excess templatecopies.

Further, for the analysis of very damaged DNA cell samples (for whichsingle cells could result in PCR products not being amplified), the useof a number of cells greater than one, i.e. two to five, allows toquantify genome integrity thus increasing the power of resolution of themethod.

EXAMPLES

In brief, several primer pairs designed on MseI fragments located ondifferent chromosomal locations and with varying fragment lengths weretested. Three primer pairs that predict successful whole genome analysisof single cell products with high specificity and sensitivity wereselected (Example 1). A fourth primer pair of a shorter MseI fragmentwas added to indicate successful DRS-WGA of low quality cells, e.g.apoptotic CTCs (Example 2). In the examples, PCR products are alsoreferred to as “markers” and PCP amplification reactions includingseveral primer pairs are also referred to as “multiplex assays”. Inparticular, PCR amplification reactions including several primer pairsdesigned to determine the integrity of the genome of a sample and/or thequality of the library of DNA sequences obtained by deterministicrestriction site whole genome amplification (DRS-WGA) of the genome ofthe sample are also referred to as “quality control assays” or “QCassays”.

Example 1

Two alternative marker combinations were shown to predict the success ofmetaphase comparative genomic hybridization (CGH) after amplification ofsingle cell genomic DNA with DRS-WGA (Resolution 10-20 Mb) on bothcancer cell samples and samples of diploid cells with normal karyotype.

A. Characteristics of the 8 Tested PCR Markers

PCRs on 8 different MseI-fragments covering an MseI-fragment length from239-1936 bp were tested (Table 1). Sequences located on 7 differentchromosome arms were selected to minimize the chance of a negative assayresult because of genomic DNA loss in a single cancer cell.

Pipetting 1.0 μl Buffer + dNTPs scheme (1x) (10 mM MgCl, 100 mM Tris (pH8.5), 500 mM KCl, 1 mM dNTPs) 0.5 μl Primer 3′ (8 μM) 0.5 μl Primer 5′(8 μM) 0.25 μl  BSA (for molecular biology) 7.25 μl  PCR-H₂O 0.1 μl Taqpolymerase (5 U/μl) 0.5 μl Ampli1 product (test sample)

Thermal profile Step 1 94.0° C. 2 min Step 2 Annealing Temp 30 s Step 372.0° C. 2 min Step 4 94.0° C. 15 s Step 5 Annealing Temp 30 s Step 672.0° C. 20 s 14 additional cycles (steps 4-6) Step 7 94.0° C. 15 s Step8 Annealing Temp 30 s Step 9 72.0° C. 30 s 24 additional cycles (steps7-9) Step 10 72.0° C. 2 min Step 11   4° C. forever

TABLE 1 Features of the 8 selected PCR primer pairs tested for the QCassay to assess DRS-WGA quality Annealing Mse-fragment PCR-fragmentPrimer name SEQ ID NO Sequence temperature Chromosome length lengthBCR-TT-R 1 TCAGCCTCAGGACTCTTGTG 61° C. 22q  1936 bp 323 bp BCR-TT-F 2CGTGGACAACTACGGAGTTG 61° C. 22q  1936 bp 323 bp D5S2117-R 3ACTGAGTCCTCCAACCATGG 58° C. 5q 1376 bp  140 bp* D5S2117-F 4CCAGGTGAGAACCTAGTCAG 58° C. 5q 1376 bp  140 bp* TRP53- 5CAGCCCAACCCTTGTCCTTA 58° C. 17p  1374 bp 299 bp Ex2/3-R TRP53- 6GAAGCGTCTCATGCTGGATC 58° C. 17p  1374 bp 299 bp Ex2/3-F CK19-R 7TTCATGCTCAGCTGTGACTG 58° C. 6q 1146 bp 614 bp CK19-F 8GAAGATCCGCGACTGGTAC 58° C. 6q 1146 bp 614 bp IGF2R-R 9GGATCTTGGTACCACTCATG 58° C. 6q  647 bp 217 bp IGF2R-F 10GCCACTGTCGAAGTCTGCA 58° C. 6q  647 bp 217 bp RUFY2-R 11CAGCTAGGAACTCCAGGAAT 64° C. 10q   458 bp 104 bp CA RUFY2-F 12GTTGAGGGCTTCATCAACAC 64° C. 10q   458 bp 104 bp CCA SMYD1-R 13CTTTTCCCTGAAGGTCTTAG 55° C. 2p  287 bp 163 bp SMYD1-F 14GGGTGACCTGCTTGACATC 55° C. 2p  287 bp 163 bp PHACTR2-R 15TGTGAGAAAGACTTGGAGTT 58° C. 6q  239 bp 205 bp PHACTR2-F 16ACTGAACAGAGCAGGTCTAC 58° C. 6q  239 bp 205 bp *This primer pairamplifies a microsatellite sequence. Therefore the actual fragmentlength can vary slightly between alleles of one patient and betweendifferent patients.

B. Selection of PCR Markers for the QC Assay

To select the best possible combination of PCR markers, 72 single cellgenomes from different types of human cancers (24 breast disseminatedcancer cells (DCCs) 24 prostate DCCs, 24 melanoma DCCs) werere-amplified. For each of the three groups, 12 cells were included whichresulted in successful metaphase hybridization in a previous CGHexperiment and 12 cells which resulted in a failed metaphasehybridization in a previous CGH experiment. Specific PCRs for allselected markers were performed and the assay was evaluated for accuracyin predicting the outcome of metaphase CGH.

As single markers, PCRs on the long Mse-fragments D5S2117, TRP53-Ex2/3and KRT19 pseudogene 1 (hereinafter also referred to as CK19) providedbest separation between amplified genomes with successful and failedmetaphase CGH. An assay of these three fragments showed high assayaccuracy in predicting the success of metaphase CGH. The addition of thePCR on the shortest Mse-fragment PHACTR2 slightly increased the assayaccuracy in the collective of 72 DCC genomes.

In summary, two alternative QC assays for the QC kit for Ampli1 weredeveloped (Table 2).

Alternative 1: QC assay with 3 markers (D5S2117, TRP53-Ex2/3 and CK19).

Alternative 2: QC assay with 4 markers (D5S2117, TRP53-Ex2/3, CK19 andPHACTR2).

TABLE 2 Assay accuracy of two alternative marker combinations for the QCassay (72 DCC samples) Statistical Alternative 1 Alternative 2measurement 2/3 PCRs+ 3/3 PCRs+ 3/4 PCRs+ 4/4 PCRs+ True+ 35 29 35 29False− 1 7 1 7 True− 34 36 35 36 False+ 2 0 1 0 Sensitivity 0.97 0.810.97 0.81 Specificity 0.94 1.0 0.97 1.0 Positive 0.95 1.0 0.97 1.0predictive value Negative 0.97 0.84 0.97 0.84 predictive value

If possible, only samples that are of the highest quality and that arepositive for all selected markers (for both alternative assays 100%specificity) should be used. However, the trade-off for applying thishigh standard of quality control is a high rate of false negatives(7/36=19.4%). If the number of test samples with the highest qualitystandard is limited, DRS-WGA amplified genomes with 2/3 or 3/4 positivePCRs still predict a high success rate for metaphase CGH (specificity0.94 for assay with 3 markers and 0.97 for assay with 4 markers,respectively).

C. Testing of PCR Markers on a set of 100 Diploid Cells with NormalKaryotype

To further test the set of PCR markers for the QC assay, 100 single cellgenomes from diploid cells with normal karyotypes were re-amplified. Allsamples were tested for the 8 different PCR markers. Additionally,metaphase CGH success was checked for 22 genomes with predicted goodquality and 10 genomes with predicted bad quality. The results of thestatistical evaluation of assay accuracy are shown in Table 3.

TABLE 3 Assay accuracy of two alternative marker combinations for theAmpli1 QC kit (32 normal samples) Statistical Alternative 1 Alternative2 measurement 2/3 PCRs+ 3/3 PCRs+ 3/4 PCRs+ 4/4 PCRs+ True+ 22 21 22 21False− 0 1 0 1 True− 10 10 10 10 False+ 0 0 0 0 Sensitivity 1.0 0.95 1.00.95 Specificity 1.0 1.0 1.0 1.0 Positive 1.0 1.0 1.0 1.0 predictivevalue Negative 1.0 0.91 1.0 0.91 predictive value

D. Further Validation of Selected QC Markers on DRS-WGA AmplifiedSamples

As the tested samples in B and C were taken from an existing biobank ofsingle cell genomes, they were amplified with DRS-WGA customizedreagents of the related labs (provided by different suppliers). Tovalidate the performance of the proposed QC assay with samples amplifiedby Ampli1 kit (as provided by Silicon Biosystems), single mononuclearPBLs and cell pools of a healthy donor and single cells and cell poolsof the breast cancer cell line SKBR3 were isolated. The markers proposedin B and C for the QC assay were used to predict quality of theamplified genomes. Then, metaphase CGH experiments for a set of samples(5 single cells, 1 cell pool and 1 Ampli1 negative control) for diploidblood cells as well as SKBR3 cells were performed to validate thepredictive accuracy of the QC assay.

SKBR: 10/11 single cells and both cell pools showed 4/4 positive bandsmarker PCRs

-   -   1/11 cells was negative for all tested markers negative control        clean in all tested PCRs        PBL: 11/11 single cells and both cell pools showed 4/4 positive        bands marker PCRs    -   negative control clean in all tested PCRs

Example 2

As other downstream analyses, e.g. Sanger sequencing for specificfragments, are not dependent on a quantitatively and qualitatively veryhigh amplification of the single cell DNA, a fourth fragment wasincluded. Experiments were carried out to test whether a successfulamplification of this sequence only is enough to predict success ofSanger sequencing of comparable Mse fragments (here PIK3CA hotspots 1and 2).

A. Protocol for 4-Multiplex Assay

In order to have compatibility with the already established 3-multiplexassay, new primers were designed for the KRAS Mse-fragment encompassingthe frequently mutated nucleotides encoding for codons 12 and 13. Theseprimers amplify a PCR fragment of 91 bp length clearly distinguishablefrom the other three bands (D5S2117, CK19 and TP53-Exon2/3, see FIG. 1).

The following pipetting scheme and thermal profile were used adding thefollowing KRAS primers in a concentration of 4 μM to the primer mix.

KRAS91bp-F (SEQ ID NO: 17) ATAAGGCCTGCTGAAAATGAC KRAS91bp-R(SEQ ID NO: 18) CTGAATTAGCTGTATCGTCAAGG

Pipetting 1.0 μl Ampli1 ™ PCR Reaction Buffer scheme (1x) (20 mM MgCl₂included) 0.2 μl dNTPs (10 mM) 1.0 μl Primer mix (8 primers, each 4 μM)0.2 μl BSA (20 mg/ml) 6.5 μl PCR-H₂O 0.1 μl Ampli1 ™ Taq polymerase (5U/μl) 1.0 μl Ampli1 ™ product (test sample)

Thermal profile Step 1 95.0° C. 4 min Step 2 95.0° C. 30 s Step 3 58.0°C. 30 s Step 4 72.0° C. 90 s 32 cycles (steps 2-4) Step 5 72.0° C. 7 minStep 6  4.0° C. forever

5 μl of each PCR product were loaded on a 1.2% agarose gel. The resultswere checked by comparing the obtained amplicons bp length with theexpected ones, as shown in table 4.

TABLE 4 PCR product identification Target Primer marker ChromosomeAmplicon length (bp) A KRAS 12p  91 B D5S2117 5q 108-166 C TRP53 17p 299D KRT19 pseudo- 6q 614 gene 1 (CK19)

As already noted above, marker B maps on a polymorphic region, thereforethe PCR products may be:

homozygous, and show one band of a bp comprised in the described range(108-166);

heterozygous and show two bands of different bp comprised in thedescribed range (108-166).

FIG. 3 shows an example of an agarose gel electrophoresis of PCRproducts obtained from different samples by using the above disclosed 4multiplex assay.

Sample 1 in FIG. 3 for example displays 3/4 positive markers. Marker Bheterozygosity or homozigosity (one or two bands) must be counted as onein the evaluation of the positivity for marker B. Samples 2 and 8 forexample display 4/4 positive markers.

B. Comparison of 4-Multiplex Assay with Results of Single Fragment PCRReactions and Established 3-Multiplex

72 DRS-WGA libraries of breast, prostate and melanoma DCC that hadalready been tested by the 3-multiplex assay of Example 1 were selected.Unfortunately the sample Breast was lost due to a fissure in thereaction tube. All other 71 DRS-WGA products were additionally testedwith KRAS 91 bp single PCR and the new 4-multiplex assay. In summary,53/71 samples showed the expected band at 91 bp in single marker PCR,and all of them but one (Breast 24) showed the same band in the4-multiplex assay. All the other bands for D5S2117, CK19 andTP53-Exon2/3 were detected in the same samples than with 3-multiplexassay. Moreover, the KRAS 91 bp amplicon was detected in all 38 samplesthat showed one or more bands in the currently used 3-multiplex.Additionally, 15 samples were identified that were negative for D5S2117,CK19 and TP53-Exon2/3 but positive for KRAS91 bp, only. Finally 18samples were negative for all four tested amplicons.

C. PIK3CA Sequencing of Ten Selected Samples

Out of the 15 samples which showed the KRAS 91 bp amplicon only, tensamples were selected for PIK3CA sequence analysis (4 breast DCCsamples, 3 prostate DCC samples, and 3 melanoma DCC samples). PIK3CAPCRs were performed for HS1 and HS2 fragments, using Ampli1™ PIK3CA SeqKit (Silicon Biosystems SpA, Italy), according to the manufacturerinstructions. After PCR all samples were loaded on a 1.5% agarose geland amplicons visualized after electrophoresis. Strong bands wereobtained only for HS1 in four DCC samples (prostate DCC 16, melanomaDCCs 13, 14, and 16) and for HS2 in five DCC samples (prostate DCCs 14,and 16, melanoma DCCs 13, 14, and 16). Additionally, weak but visiblebands were detected for an additional two (breast DCC 13, prostate DCC24) and three samples (breast DCCs 13, and 15, prostate DCC 24),respectively (FIG. 2). One sample (melanoma DCC 16) showed a strongsmear for DNA fragment ≥1 kb, which was also visible in all previousgels of this sample. Nevertheless, the PCR amplicon was purified for allsamples and sequenced.

Sanger sequencing for PIK3CA mutational hotspots resulted in very strongand clean sequences for the samples showing strong amplification in gelelectrophoresis (see FIG. 2), including sample melanoma DCC 16. Most ofthe other samples with lower amplicon concentration showed highbackground noise, although sequences could easily be edited for twoadditional samples for HS1 (breast DCC 13, prostate DCC 24) and fouradditional samples for HS2 (breast DCCs 13, 15, and 20, prostate DCC24). For the remaining samples background signal was too high for asecure editing of the complete sequence (breast DCCs 15, 17, and 20,prostate DCC 14 for HS1; breast DCC 15 for HS2).

On a collective of CTCs and White Blood Cells (WBCs) harvested withDEPArray™ (Silicon Biosystems SpA) from breast cancer patientsperipheral blood enriched with CellSearch® (Jannsen Diagnostics LLC),the Genome Integrity was assessed by analysing the quality of Ampli1™WGA product according to the invention. The resulting number of PCRproducts detected following the multiplex PCR reaction (Genome IntegrityIndex or GII) was found to be significantly skewed, as shown in FIG. 4,toward lower values of GII in CTCs with respect to normal WBCs collectedfrom the same patients, undergoing the same process of enrichmentsorting and Ampli1™ WGA.

By way of explanation, a GII with a value of 0 corresponds to asituation in which none of the first, second, third or fourth PCRproducts is amplified, a GII with a value of 1 corresponds to asituation in which only the fourth PCR product is amplified, a GII witha value of 2 corresponds to a situation in which one among the first,second and third PCR products and the fourth PCR product are amplified,a GII with a value of 3 corresponds to a situation in which two amongthe first, second and third PCR products and the fourth PCR product areamplified, and a GII with a value of 4 corresponds to a situation inwhich the first, second, third and fourth PCR products are amplified.

The GII was further used to assess the success rate of targeted Sangersequencing for PIK3CA exon 9 and exon 20 mutation hotspots, of a customqPCR assay to determine the amplification of ERBB2 gene, and of arrayCGH. Table 5 shows a synopsis of the results.

TABLE 5 P Value Molecular Analyzed Genome Integrity Index (GII) Chi-assay cells GII 0 GII 1 GII 2 GII 3 GII 4 square PIK3CA HS1 n = 383 7/2314/25 48/62 102/117 146/156 <0.0001 (30.4%) (56.0%) (77.4%) (87.2%)(93.6%) PIK3CA HS2 n = 383 8/23 18/25 55/62 109/117 149/156 <0.0001(34.8%) (72.0%) (88.7%) (93.2%) (95.5%) PIK3CA n = 383 4/23 12/25 45/62 97/117 141/156 <0.0001 complete (17.4%) (48.0%) (72.6%) (82.9%) (90.4%)HER2 qPCR n = 351 3/12  8/18 41/61  95/112 136/148 <0.0001 (25.0%)(50.0%) (67.2%) (84.8%) (91.9%) aCGH n = 50 Not Not 4/5 7/9 36/36 0.016assessed assessed (80.0%) (77.8%)  (100%)

The above examples show that the method according to the presentinvention allows to determine the integrity of the genome of a sampleand the quality of a library of DNA sequences obtained by DRS-WGA of thegenome of the sample with robust and reliable results and allows inparticular to predict the performance of molecular assays, such asmetaphase and array comparative genomic hybridization (CGH), Sangersequencing and qPCR, downstream of the DRS-WGA.

From an analysis of the features of the method and kit of the presentinvention, the resulting advantages are apparent.

In particular, in virtue of the fact that DRS-WGA is based on specificrestriction digestion of double stranded DNA at MseI site (TTAA) andligation of one universal adaptor for amplification, in principle allfragments generated during amplification that represent the WGA libraryare known. Thus, by the identification of specific MseI fragments havinga length of >1000 bp in a single cell WGA library, the genomic integrityof the DNA of an isolated cell can be measured, and thus the quality ofthe sample for different kinds of successful molecular analysisdetermined.

Since the first, second and third primer pairs have been specificallyselected in target regions of the genome corresponding to long ampliconsof the DRS-WGA DNA digestion enzyme, MseI, which are more difficult toamplify in case of DNA fragmentation, their amplification is indicativeof good overall success of the DRS-WGA on a given sample.

Further, in virtue of the fact that the first, second and third primerpairs are designed on different chromosome arms, the method allows toassess the integrity of the genome of a sample and/or the quality of thelibrary of DNA sequences obtained over the broadest region of thegenome.

Further, in virtue of the fact that the first, second, third and fourthPCR products have different size, it is possible to use the first,second, third and fourth primer pairs together in a multiplex reaction.

Moreover, in virtue of the fact that the fourth primer pair hybridisesto a DNA sequence of the library having a length from 80 bp to 300 bp,it is possible to predict the performance of molecular assays downstreamof the DRS-WGA also for low quality cells, for example apoptotic CTCs.In fact there is a significant difference in performance between thesuccess rate in e.g. targeted sanger sequencing of the PIK3CA exon 9(30%) and exon 20 (34%) or qPCR for Her2 CNV analysis (25%) of cells forwhich not even this fourth PCR product is amplified and those cells forwhich at least this is amplifiable, for which the success rate roughlydoubles (56%, 72%, 50% respectively). The two populations wouldotherwise be indistinguishable when using only the 3 primer pairshybridizing to long amplicons of the DRS-WGA.

Finally, it is clear that modifications and variants to the method andkit disclosed and shown may be made without because of this departingfrom the scope of protection of the appended claims.

In particular, the method may be multiplexed by using further pairs ofprimers which do not interfere with the PCR amplification with thefirst, second, third and possibly fourth primer.

1-15. (canceled)
 16. A kit for determining the integrity of the genomeof a sample and/or the quality of a library of DNA sequences obtained bydeterministic restriction site whole genome amplification (DRS-WGA) ofthe genome of the sample, the kit comprising: at least one first primerpair which hybridizes to a DNA sequence of the library having a lengthfrom 1000 bp to 5000 bp and encompasses the D5S2117 region of chromosome5q, at least one second primer pair which hybridizes to a DNA sequenceof the library having a length from 1000 bp to 5000 bp and encompassesexons 2 and 3 of the TRP53 gene of the genome, and at least one thirdprimer pair which hybridizes to a DNA sequence of the library having alength from 1000 bp to 5000 bp and encompasses the KRT19psuedo-gene 1 ofthe genome, wherein the first, second and third primer pairs give rise,when amplified by PCR, to PCR products having different size from oneanother.
 17. The kit of claim 16, wherein when amplified by PCR, thefirst second, and third primer pairs give rise to a first PCR productfrom 50 bp to 1000 bp, a second PCR product from 50 bp to 1000 bp havinga size other than the first PCR product, and a third PCR product from 50bp to 1000 bp having a size other than the first and second PCRproducts.
 18. The kit of claim 16, wherein a forward primer of the atleast one first primer pair is SEQ ID NO:4 and a reverse primer of theat least one first primer pair is SEQ ID NO:3.
 19. The kit of claim 16,wherein a forward primer of the at least one second primer pair is SEQID NO:6 and a reverse primer of the at least one second primer pair isSEQ ID NO:5.
 20. The kit of claim 16, wherein a forward primer of the atleast one third primer pair is SEQ ID NO:8 and a reverse primer of theat least one third primer pair is SEQ ID NO:7.
 21. The kit of claim 16,further comprising instructions to amplify the library of DNA sequencesby PCR using the at least one first primer pair, the at least one secondprimer pair, and the at least one third primer pair, and to detect thefirst, second, and third PCR products, wherein the presence of any oneor more of the first, second, and third PCR products corresponds to alevel of the integrity of the genome of the sample and/or the quality ofthe library of DNA sequences.
 22. The kit of claim 16, furthercomprising at least one fourth primer pair which hybridizes to a DNAsequence of the library having a length from 80 bp to 300 bp, wherein,when amplified by PCR, a fourth PCR product results having a size otherthan the first, second, and third PCR product.
 23. The kit of claim 22,wherein the fourth PCR product is from 50 bp to 200 bp.
 24. The kit ofclaim 22, wherein the DNA sequence of the library to which the at leastone fourth primer pair hybridises encompasses Codon 12/13 of the KRASgene.
 25. The kit of claim 23, wherein a forward primer of the at leastone fourth primer pair is SEQ ID NO:17 and a reverse primer of the atleast one first primer pair is SEQ ID NO:18.
 26. The kit of claim 22,further comprising instructions to amplify the library of DNA sequencesby PCR using the at least one first primer pair, the at least one secondprimer pair, the at least one third primer pair, and the at lea tonefourth primer pair and to detect the first, second, third, and fourthPCR products, wherein the presence of any one or more of the first,second, third, and fourth PCR products corresponds to a level of theintegrity of the genome of the sample and/or the quality of the libraryof DNA sequences.
 27. The kit of claim 16, wherein the sample consistsof 5 cells or less.
 28. The kit of claim 16, wherein the sample is asingle cell.
 29. A method of predicting the success of a geneticanalysis assay after amplification of single cell genomic DNA by DRS-WGAcomprising amplifying a library of DNA sequences by PCR using the kit ofclaim 16 and detecting the first, second, and third PCR products. 30.The method of claim 29, wherein the genetic analysis assay is selectedfrom the group consisting of Sanger sequencing for mutation analysis,assessment of specific copy number chambers, quantitative PCR for geneamplification, metaphase Comparative Genomic Hybridization (CGH), andarray Comparative Genomic Hybridization (CGH).
 31. A method ofdetermining the integrity of the genome of a sample, comprisingamplifying a library of DNA sequences by PCR using the kit of claim 16and detecting the first, second, and third PCR products.
 32. The methodof claim 31, wherein determining the integrity of the genome of a sampleallows to determine a biological status of the cell/cells of the sample.